TABULATIONS1 of the causes of spontaneous hypoglycemia usually allot an important role to disease of the liver, and it has been emphasized that hepatic disease is one of the three most common causes of spontaneous hypoglycemia.1a,b Rapidly developing hypoglycemia has been described in the hepatectomized dog,2 and severe hypoglycemia has been reported in patients with fatty metamorphosis,3 cirrhosis,4 and carcinoma5 of the liver, as well as in those with infectious6 and toxic7 hepatitis. The number of patients, however, reported to have hepatic disease and hypoglycemia has been relatively few, and spontaneous hypoglycemia has been extremely rare in a large number of patients with hepatic disease observed by the authors. Conversely, fasting hyperglycemia has been noted in intrinsic hepatic disease.8 Accordingly, an appraisal of the fasting blood sugar level and its correlation with the severity of the liver disease seemed indicated. Such data were available for 269 patients.9
ZIMMERMAN HJ, THOMAS LJ, SCHERR EH. FASTING BLOOD SUGAR IN HEPATIC DISEASE WITH REFERENCE TO INFREQUENCY OF HYPOGLYCEMIA. AMA Arch Intern Med. 1953;91(5):577–584. doi:10.1001/archinte.1953.00240170003001
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